ลักษณะของผู้ป่วย การรักษา และผลลัพธ์ของภาวะหืดกำเริบเฉียบพลันรุนแรง ในหออภิบาลผู้ป่วยเด็กวิกฤต จังหวัดนครศรีธรรมราช

Thanatchaya  Chumsri

Authors

Thanatchaya Chumsri Department of Pediatrics, Maharaj Nakhon Si Thammarat Hospital

Keywords:

Acute life-threatening asthma exacerbations, intubation, pediatric intensive care unit

Abstract

Background: Acute life-threatening asthma exacerbations (ALTA) is a significant problem in the pediatric intensive care unit (PICU) and intubation is associated with complications and prolonged hospitalizations.

Objective: This study aimed to identify the patient risk factors associated with intubation and to examine the treatment in PICU and outcomes of ALTA

Materials and Methods: A retrospective study was conducted by reviewing the medical records of all children aged 1–15 years diagnosed with ALTA who were admitted to the PICU of Maharaj Nakhon Si Thammarat Hospital between January 1, 2023 and December 31, 2024.

Results: A total of 92 pediatric patients were included, of whom 69 were intubated and 23 were not. The intubated group had a higher proportion of patients referred from other hospitals (p < 0.01) and lower proportions with a prior asthma diagnosis (< 0.01) or use of controller medications (p < 0.01) compared to the non-intubated group. Before PICU admission, the intubated group was less likely to have received corticosteroids (p = 0.04). In the PICU, the lower proportion of patient in the intubated group received 50% MgSO₄ (p = 0.021), whereas continuous β₂-agonist infusions were required more frequently than in the non-intubated group (p = 0.02). There were no deaths in either group. The intubated group had a longer PICU length of stay (4.7 ± 2.3 days vs 2.2 ± 1.0 days, p < 0.01) and a longer total hospital length of stay (8.7 ± 4.0 days vs 5.4 ± 1.3 days, p < 0.01) than the non-intubated group.

Conclusions: Risk factors associated with intubation in this study included referral from another hospital, absence of a prior asthma diagnosis, lack of controller medication use, and inadequate pre-PICU management. These factors were also associated with longer PICU and total hospital length of stays.

Keyword: Acute life-threatening asthma exacerbations; intubation; pediatric intensive care unit

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